Wednesday, June 17, 2009

Single-Payer Socialism or Just Plain Smart?

Other nations have long enjoyed national health plans, while in the United States, a major Health Plan war is developing.

If so many other national health care programs have long been operational across the globe, so why not the United States?

It's been tried before. And defeated before.

Once, again, the major health insurance companies, the Chamber of Commerce, the Republicans, and other powerful conservative lobbies, are building an enormous campaign to stop the new attempt, this one by President Obama.

The Obama administration is driving toward the plan model known as "Single-payer." It means this. Citizens pay one insurer, the single-payer, the government agency--- who negotiates with all health professionals, and pays all the bills, at preset rates.

Obviously, this plan would give great leverage to the government, in negotiating prices of health care. Patients desiring other types of care would be free to consult health professionals on their own, with their own money.

Its easy to see why big insurers are fighting this. Insurance companies would be marginalized, to say the least. They claim it wont work.

So what about the other nations with national plans? How does it work there?

Single-payer is the type of plan that has made France such a successful health provider for its citizens. It is also similar to the plans utilized by Britain, Australia, Canada, and many other countries, with varying success. But they have one thing surprisingly in common--- those nations spend less on average health care for their citizens. One study found that, in 2004, the United States health care, per capita, cost about $6100, compared to about $3200 in Canada, $3160 in France, $3,120 in Australia, and only $2500 in Britain.

These numbers are hard evidence that single-payer can work, at least economically. The quality of health care between nations is more hotly debated.

Opponents of Obama's plan cry socialism. But the fact is, United States health care has long been government supported. More than half of patient costs at many hospitals are paid by government programs, even now. Obama has just proposed to pull over 300 billion dollars from those subsidies to help pay for national health care.

In 2001, France's health system was rated #1 by the World Health Organization. The United States was ranked #37. Even though French costs per capita were roughly half the U.S. costs. How can this be? What are the French doing right, so right?

The #1 ranking for the french was partly based upon the long life and excellent average health of its population. One variable might be that the French do not suffer the obesity and associated diabetes epidemic that is so exponentially devastating in the United States. Many French citizens eat healthier food and exercise more. The burden on their heath care costs is drastically lowered as a result, even though they enjoy longer lives.

We must wonder whether Obama's plan might require, at the least, no smoking and a moderate body-mass-index for United States plan participants? The plan's opponents would no doubt argue exclusion and prejudice. There is nearly an endless list of risky lifestyles that would add to the cost of a national plan, if not addressed.

Interestingly enough, the French do not consider their national plan to be socialism. It is voluntary, but highly popular. In fact, French physicians have embraced the plan by a nearly 100 per cent membership. The government does all their charging and billing and payment operations. In French doctor's offices there are only doctors and nurses. And the French society itself disdains litigation, including the kind of malpractice litigation so common in the United States.

But what about the big United States insurers? They have stopped other plans in the past. The French found a way. They won over their insurance companies to their plan simply by allowing the present insurers themselves to administer the new national plan. One wonders whether the United States will soon bring this possibility to the bargaining table?

There are many other differences to overcome. In the United States, insurers give less coverage to the most ill. In France, more coverage is given to those who are the most ill.

In time, such hurdles may be overcome by the Obama Administration. Other nations have certainly made it happen. But never in a period of such economic uncertainty.

Even the French may be forced soon to raise taxes to maintain their own plan--- if they must they will, for national health is to the French a sacred trust with their citizenry.